© 2003 The Royal College of Psychiatrists
Assertive outreach teams in London: models of operation
Pan-London Assertive Outreach Study, Part 1
Department of General Psychiatry, St George's Hospital Medical School and South West London and St George's Mental Health Trust, London
Department of Psychiatry and Behavioural Sciences, University College London and Camden and Islington Mental Health and Social Care Trust
Sainsbury Centre for Mental Health
Unit for Social and Community Psychiatry, Barts and The London School of Medicine
Sainsbury Centre for Mental Health
Unit for Social and Community Psychiatry, Barts and The London School of Medicine
Biostatistics Unit, Cambridge
Correspondence: Dr Christine Wright, Social and Community Psychiatry, Department of Mental Health, St George's Hospital Medical School, Cranmer Terrace, Tooting, London SW17 0RE, UK. E-mail: cwright{at}sghms.ac.uk
Declaration of interest Funding provided by the Department of Health.
See Parts 2 and 3, pp.
139–154, this issue.
Background Assertive outreach teams have been introduced in the UK, based on the assertive community treatment (ACT) model. It is unclear how models of community care translate from one culture to another or the degree of adaptation that may result.
Aims To characterise London assertive outreach teams and determine whether there are distinct groups within them.
Method Semi-structured interviews with team managers plus one month's prospective process of care data collection were used to test for ‘model fidelity’ to ACT and, by cluster analysis, to identify groupings.
Results Fidelity varied widely, with four teams (out of 24 studied) rated ‘high fidelity’ and three teams rated ‘low fidelity’ by US standards and 17 rated ‘ACT-like’. Three clusters were identified, with voluntary sector teams being the most distinct group.
Conclusions There is wide variation in the practice of assertive outreach in London. The role of the voluntary sector requires increased attention. Heterogeneity in practice is a clinical challenge but a research opportunity in distinguishing effective from redundant components of the approach.
Related articles in BJP:
- Assertive outreach teams in London: staff experiences and perceptions: Pan-London Assertive Outreach Study, Part 2
- JOANNE BILLINGS, SONIA JOHNSON, PAUL BEBBINGTON, ADELE GREAVES, STEFAN PRIEBE, MATT MUIJEN, IAIN RYRIE, JOANNA WATTS, IAN WHITE, and CHRISTINE WRIGHT
BJP 2003 183: 139-147.[Abstract] [Full Text] - Assertive outreach teams in London: patient characteristics and outcomes: Pan-London Assertive Outreach Study, Part 3
- STEFAN PRIEBE, WALID FAKHOURY, JOANNA WATTS, PAUL BEBBINGTON, TOM BURNS, SONIA JOHNSON, MATT MUIJEN, IAIN RYRIE, IAN WHITE, and CHRISTINE WRIGHT
BJP 2003 183: 148-154.[Abstract] [Full Text] - Highlights of this issue
- ELIZABETH WALSH
BJP 2003 183: 89-a7.[Full Text]
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